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JAMA Clinical Challenge
January 31, 2019

Blurry Vision and a Black Ink Tattoo

Author Affiliations
  • 1Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St Louis, Missouri
JAMA. 2019;321(7):699-700. doi:10.1001/jama.2018.20671

A 26-year-old white man presented for evaluation of blurry vision over the past year. He had no back or joint pain or skin rashes. Five years ago he had a black ink tattoo placed on his left arm, and 3 years ago a second tattoo was placed on his right arm. Two years after the right arm tattoo was placed, he noticed tattoo elevation on the left arm and onset of decreased vision. He had recurrent episodes of ocular redness and blurred vision, coincident with inflammation of the skin surrounding both tattoos. Two months before presentation, bilateral peripheral iridotomies (iris laser procedures) were performed because of inflammation-induced adhesions between the iris and the lens (Figure, panel A).